Provider Demographics
NPI:1366701070
Name:GALLETLY, HELEN L (MED)
Entity type:Individual
Prefix:MS
First Name:HELEN
Middle Name:L
Last Name:GALLETLY
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 16TH ST S
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33705-2231
Mailing Address - Country:US
Mailing Address - Phone:727-542-6476
Mailing Address - Fax:727-896-1426
Practice Address - Street 1:1001 16TH ST S
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33705-2231
Practice Address - Country:US
Practice Address - Phone:727-542-6476
Practice Address - Fax:727-896-1426
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-15
Last Update Date:2012-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor